Patwardhan M, Samsa G, Fisher D, Mantyh C, Morse M, Prosnitz R; Health Technology Assessment International. Meeting (3rd : 2006 : Adelaide, S. Aust.).
Handb Health Technol Assess. 2006; 3: 68.
Duke University Medical Centre, Duke Centre for Clinical Health Policy Research, 2200 W Main Street,
Introduction: Reliable quality measures (QMs) are a pre-requisite to measuring quality of health care. We conducted a systematic literature review to identify and evaluate colorectal cancer (CRC) QMs related to colonoscopy. Methods: We searched MEDLINE and Cochrane databases for publications that included QMs pertaining to colonoscopic evaluation of individuals who: present with abnormal screening results, CRC symptoms, or undergo colonoscopic surveillance. We confined our search to process measures based on US data published after 1990. Two reviewers independently reviewed abstracts and full-text articles, and rated them on a scale of 1-5 (1=poor, 5=ideal, x=information not available) based on importance (I), scientific acceptability (S), and extent of testing (T). Results: 3,429 abstracts and 843 full-text articles were evaluated, and 23 articles were studied. We retrieved 15 measures that assessed the quality of diagnosis for CRC through endoscopic visualization and biopsy for CRC, five measures evaluating colonoscopy technique and six measures appraising colonoscopic surveillance.The best in each category were: percentage of patients with a positive fecal occult blood test who underwent appropriate evaluation (I5S5T4)), cecal intubation rate (I5S4TX), and percentage of patients with CRC receiving postoperative colonoscopy (I5S4T5). Conclusions: Several measures that assessed colonoscopic CRC detection and surveillance are available. These measures need to be improved by establishing an explicit linkage to outcomes, precisely defining numerators and denominators, and field testing so they are relevant for policy-makers and payors. We noted gaps in literature that identify areas for future research: absence of an appropriate surveillance timeframe, and lack of standardized procedure notes.
Publication Types:
Keywords:
- Colonoscopy
- Colorectal Neoplasms
- Genetic Screening
- Humans
- Mass Screening
- Occult Blood
- Quality of Health Care
- United States
- Weights and Measures
- diagnosis
- methods
- organization & administration
- hsrmtgs
UI: 103724834
From Meeting Abstracts